Good character,paedophilia and the purposes of sentencing: Ryan v The Queen [2001] HCA 21; (2000) 118 A Crim 438

In Ryan v The Queen [2001] HCA 21; (2000) 118 A Crim 438 the Australian High Court was called upon to analyse further the role of evidence about “good character”. It did so in the emotionally charged context of a Catholic priest's serial offending against attar boys and boys attending parish schools within his supervision. The Court was split about the significance of the offender's history of constructive contribution to the community and as to whether that should in the circumstances be regarded as indicative of “good character” and such as to “earn” him a sentencing “credit” or “discount”. This article discusses the ramifications of the High Court's decision for the ongoing utility of the concept of “good character” and what the various judgments betoken for the construction of legislative and sentencing policy in relation to those suffering from paedophilia and other disorders falling short in law of “mental illnesses”.     

Evidence,Policies and Practices: Continuities and Discontinuities in Mental Health Promotion in a Developing Country

The relationship between research evidence, policy and implementation is complex throughout the world, but where resources are scarce (especially in developing countries) there is a need to ensure rational implementation. With reference to a study on which we work, we show how the simple act of conducting research where resources are lacking affects implementability. We discuss five key issues with which researchers must engage if they wish to affect policy and implementation: evidence is not the only criterion by which implementation decisions are made, implementation decisions are often political rather than health-oriented in the narrow sense, there is often a difference in time scale between research enterprises and policy implementation, moving from research to the ‘real world’ requires engagement with existing organisational systems, and we need to be able to tell the difference between changes in rhetoric and changes in the real world. The broad international context of funding and the scientific community also affect how researchers work in developing countries. We suggest that engagement with these apparently ‘non-scientific’ concerns is essential to the work of researchers.     

Language Learning From Positive Evidence,Reconsidered: A Simplicity‐Based Approach

Children learn their native language by exposure to their linguistic and communicative environment, but apparently without requiring that their mistakes be corrected. Such learning from “positive evidence” has been viewed as raising “logical” problems for language acquisition. In particular, without correction, how is the child to recover from conjecturing an over‐general grammar, which will be consistent with any sentence that the child hears? There have been many proposals concerning how this “logical problem” can be dissolved. In this study, we review recent formal results showing that the learner has sufficient data to learn successfully from positive evidence, if it favors the simplest encoding of the linguistic input. Results include the learnability of linguistic prediction, grammaticality judgments, language production, and form‐meaning mappings. The simplicity approach can also be “scaled down” to analyze the learnability of specific linguistic constructions, and it is amenable to empirical testing as a framework for describing human language acquisition.     

Report on the European Association of Body Psychotherapy: Bodies of Knowledge: Resources for a World in Crisis

The heterogeneous field of body oriented psychotherapy (BOP) provides a range of unique contributions for the treatment of mental disorders. Practice based clinical evidence and a few empirical studies point towards good efficacy of these non-verbal intervention strategies. This is particularly relevant for those disorders with body image aberration and other body-related psychopathology, but also for mental disorders with limited treatment response to traditional talking therapies, e.g. somatoform disorders/medically unexplained syndromes, PTSD, anorexia nervosa or chronic schizophrenia. However, the evidence base is not yet sufficiently developed in order to get BOP recognised as suitable mainstream treatment by national health services and their commissioning bodies. Strong academic links are urgently required in order to support practitioners in their efforts to evaluate the clinical work in systematic research. The field would greatly benefit from the development of international higher education training in integrated clinical body psychotherapy, enabling practitioners to obtain a master's degree. From a scientific perspective, projects on the interface between neuroscience and psychotherapy research should be conducted in order to understand more fully the therapeutic processes in BOP, particularly with regard to emotional processing, movement behaviour and body/self perception. Qualitative research is needed to further investigate the specific interactive therapeutic relationship, the dynamics of touch in psychotherapy and the additional self-helping potential of creative/arts therapy components. Provided that these requirements will be fulfilled, BOP could be established as one of the main psychotherapeutic modalities in clinical care, alongside other mainstream schools such as psychodynamic, cognitive-behavioural and systemic.     

Improving oral healthcare using academic detailing – design of the ADVOCATE Field Studies

Background: Academic detailing (AD) is a defined form of educational outreach that can be deployed to intrinsically motivate practitioners towards improving quality of care. This paper describes the design of the ADVOCATE Field Studies. This proof of concept study aims to evaluate the feasibility, acceptability and usefulness of AD, reinforced with feedback information to promote prevention-oriented, patient-centred and evidence-based oral healthcare delivery by general dental practitioners (GDPs).

Methods: Six groups of GDPs will be recruited; two groups of six to eight GDPs in each of three countries – the Netherlands, Germany and Denmark. GDPs will meet for four Academic Detailing Group (ADG) meetings for open discussions using comparative feedback data to stimulate debate about their dental practice performance and care delivery. Group meetings will be moderated using the AD methodology. Qualitative data will be collected through focus group interviews, an online discussion forum, field notes and debriefs of ADG meetings and analysed by conventional content analysis using MaxQDA software.

Discussion: The results of the study will provide novel information on the feasibility, perceived acceptability and usefulness of AD and feedback data for GDPs to improve oral healthcare delivery.     

Do Implant Length and Width Matter for Short Dental Implants (<10 mm)? A Meta‐Analysis of Prospective Studies

Background: This meta‐analysis of prospective clinical trials was conducted to determine the effects of dental implant length and width on implant survival rate of short (<10 mm) implants. Methods: An electronic search of the PubMed database for relevant studies published in English from November 1998 to March 2012 was performed. Selected studies were randomized clinical trials, human clinical trials, or prospective trials with a clear aim of investigating the success or survival rate of short (<10 mm) implants. Results: Eight studies fulfilled the inclusion criteria and were subsequently analyzed. A total of 525 short (<10 mm) dental implants were analyzed, of which 253 were 3.5 mm in diameter (48.19%), 151 were 4.0 mm (28.76%), 90 were 4.1 mm (17.14%), 21 were 4.8 mm (4%), and 10 were 5.1 mm (1.9%). All implants included in this meta‐analysis had a follow‐up period of 12 to 72 months. The included studies reported on the survival rate and diameter of the implants. Six of the studies used “short implants” (7 to 9 mm), and the remaining were classified as “extra‐short implants” (≤6 mm). Five‐year estimated failure rates were 1.61% and 2.92%, respectively, for extra‐short and short implants (z = ?3.49, P <0.001, 95% confidence interval = 0.51% to 4.10%). Furthermore, it was found that the wider the implant, the higher the failure rate (estimated failure rate = 2.36%, 95% confidence interval = 1.07% to 5.23%). Conclusions: Neither implant length nor width seemed to significantly affect the survival rate of short implants (<10 mm). Nonetheless, further well‐designed randomized clinical trials are needed to confirm these findings.     

Task Group for Orthodontics Report.

Abstract

The UK Specialist Review Group of the General Dental Council's Education Committee has been charged with taking forward the recommendations in the Chief Dental Officer's report 'UK Specialist Dental Training'. The Specialist Review Group has, in turn, established a number of specialty task groups. This report is from the Task Group for Orthodontics. It was submitted in May 1996.     

RETRACTED: Early outcome of arthroscopic Bankart's repair for Recurrent traumatic anterior shoulder instability

Background/objectives

Despite the improvements in the methods of arthroscopic stabilization of anterior shoulder instability, a recurrence rate of as high as 30% is reported in the literature. In this context, we report the outcome of arthroscopic Bankart repair in anterior shoulder instability, with the use of bio-absorbable suture anchors for patients that were followed up for at least two years from the date of surgery.The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2-year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder.

Methods

Data from 79 shoulders in 74 patients were collected over 4 years (2005–2009). Each patient was followed up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their anterior shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA) shoulder rating scale and the Simple Shoulder Test (SST) score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated.

Results

SST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p < 0.0001). Data from the UCLA scale showed a pre and post-operative mean of 20.2 ± 5.0 and 32.4 ± 4.6 respectively (p < 0.0001). 34 had excellent post-operative scores, 35 had good scores, 1 had fair score and 3 had poor scores. 75% of the patients returned to sports while 7.6% developed a recurrence of shoulder dislocation or subluxation.

Conclusion

Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.